Myocarditis.pptx

For 2nd year year B.Sc. Nursing students.

1. MYOCARDITIS Presented By: Mr. Nandish.S Asso. Professor Mandya Institute of Nursing Sciences

2. DEFINITION : It is a focal or diffuse inflammation of the myocardium. It is the inflammatory process involving the myocardium, can cause heart dilation, thrombi on heart wall, infiltration of circulating blood cells & degeneration of muscle fibres. It is an inflammation of heart muscle (myocardium). It can affect electrical conductive system of heart reducing heart’s ability to pump blood.

3. ETIOLOGY & RISK FACTORS : Infections Viral : Coxsackievirus A and B, Echovirus, Influenza A and B, Mumps virus, Adenovirus. Bacterial Rickettsial Fungal Parasitic Spirochetal Protozoal ( Chagas disease) infection. 2. Systemic Lupus Erythematosus 3. Immunosuppressive Therapy Continued …..

4. 4. Rheumatic Fever 5. Autoimmune disorder 6. Infective Endocarditis 7. Radiation Therapy 8. Side effects of Medication – Penicillin, Sulfonamides 9. Idiopathic

5. PATHOPHYSIOLOGY : Due to infection (viral or bacterial) Activation of macrophages & Lymphocytes Release of cytokinase Activation of fibroblast & remodelling Increased collagen synthesis Fibrosis Dilated & Ischemic cardiomyopathy

6. CLINICAL FEATURES : Features are variable ranging from without any overt manifestations to severe heart involvement or sudden death. Fever Fatigue / Malaise Myalgia Dyspnoea Lymphadenopathy Nausea & Vomiting Syncope Continued …

7. Cardiac signs : They appear 7 to 10 days after cardiac infections. Pericardial chest pain S3 sound will heard during auscultation Crackles Jugular venous distension Peripheral Oedema Congestive Heart Failure.

8. DIAGNOSTIC STUDIES : History collection & Physical Examination ECG : ST segment abnormalities Chest X- Ray CBC : Leukocytosis Increased ESR & CRP Cardiac Markers : increased C reatine Kinase Endomyocardial Biopsy (EMB) Echocardiography Cardiac MRI

9. MANAGEMENT : Medical : Corticosteroids : prednisone Digoxin Oxygen therapy Immunosuppressive therapy : Azathioprine, cyclosporine Antibiotics Intravenous immunoglobulin Antiviral drugs – Ribavirin, ά Inferon .

10. In severe cases, Ventricular Assist Device (VAD) Ventricular Assist Device, they are mechanical pumps that help pump blood from lower chambers of heart (ventricles) to rest of the body. They are used in people who have weakened heart or heart failure. This treatment may be used to allow the heart to recover while waiting for the other treatment.

11. Intra Aortic Balloon Pump (IABP) It is a device that helps your heart to pump more blood. It is recommended when your heart is not pumping enough blood through circulatory system. A catheter (balloon attached) is inserted into an artery in your leg. Use imaging technology to guide balloon & aorta to aorta. IABP is attached to a machine that tells balloon when to inflate & deflate. It helps heart to increase the blood flow & decrease the workload.

12. Extracorporeal Membrane Oxygenation (ECMO) It is also known as extracorporeal Life support. Extra corporeal means outside the body. This will help a person whose lungs and heart are not functioning properly. During this treatment, blood flows out of your body through a tube in the large blood vessel (in chest, in groin or in neck). A pump pushes your blood through tubes that carry it to a machine. It adds oxygen and removes carbon dioxide from blood. Then the machine pumps your blood back into your body. Since ECMO is a complex set up, it is used only in extreme cases.

13. Nursing Management : Pain, Acute in chest related to infection & inflammation of myocardium. Decreased cardiac output related to left ventricular incompetency. Activity intolerance related to increased oxygen demand and insufficient oxygen supply. Risk for ineffective tissue perfusion, related to decreased cardiac output. Anxiety related to disease condition and treatment.

14. THANK YOU